"All that we are is the result of what we have thought. The mind is everything. What we think we become.” -BUDDHA

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MEDIUM CHAIN TRIGLYCERIDES: COGNITIVE & OTHER BENEFITS

Frankly, I had not paid much attention to the details of medium chain triglycerides (MCT’S) until I read the story of a doctor whose husband had dementia. His cognitive function was poor. However, when she gave him MCT'S, he improved significantly …. as long as he ate a low carbohydrate diet. If he did not eat a low carbohydrate diet, the effects were not as dramatic. I became intrigued, and of course set about to investigate.

Although the normally functioning brain relies primarily on glucose for its fuel, in Alzheimer’s Disease there are early & region specific pathological declines in the brains ability to use glucose. Luckily, the brain is capable of using alternative fuels. This ability of the brain to adapt toward using other fuels is augmented by a low carbohydrate diet (10-20 grams of carbohydrates daily), such as the famous Dr Atkins’ Diet . The low carbohydrate diet causes the body to burn its own fat for fuel. When body fat is burned , the process creates what are called ketone bodies (beta hydroxyl butyrate), or a state of “ketosis” in the body. The ketones can function as an alternate fuel for the brain. Though unable to adequately use glucose, the Alzheimer’s brain can use ketones.

The above mentioned low carbohydrate diet is called a ketogenic diet. A low carbohydrate intake forces your body to burn it’s own fat to produce energy. Your body fat is then broken down to form ketones. This forces a ketone-based rather than glucose based cellular metabolism throughout your body and in your brain. This shift in fuels influences the major inhibitory and excitatory neurotransmitter systems in the brain. This type of diet has been extensively researched for use in various medical conditions. The ketogenic diet has long been used to manage intractable epilepsy in children when medications have failed. When the brain is switched away from glucose and toward the ketones & fatty acids for fuel, it seems to quiet overactive processes & modulate a malfunctioning brain.

I sure started thinking about how this might work with obsessive-compulsive disorder to quiet the repetitive thought processes and brain over activity. So I looked for research on that subject but didn't find much. It’s certainly worth exploring, and even worth a trial in those with this problem. Throughout my career I have noted sugar or junk carbohydrate intake worsened symptoms in my patients with OCD. I have asked them to avoid all sugar & white flour as unwanted triggers. But we did not use a ketogenic diet to actually produce alternative brain fuels.

Many studies support the efficacy of the ketogenic diet in altering brain function. Here are a couple of interesting ones and their subsequent outcomes re developing a new prescription treatment for cognitive dysfunction.

An oral ketogenic compound called AC-1202 was made into a milkshake called Ketasyn. This was used in subjects diagnosed with mild to moderate Alzheimer’s in a 90 day randomized double-blind placebo controlled study. There was a significant improvement in the Alzheimer's Disease Assessment Scale, (ADAS-Cognitive) scores at days 45 and 90 in those on the AC-1202. This worked well in the 50% of the subjects not carrying the ApoE4 Alzheimer’s gene, but not as well in those with the gene. There were a couple of clinical trials with this.

What is the therapeutic food in Axona? The main ingredient is Caprylic acid , a medium chain triglyceride produced by processing coconut oil and palm kernel oil. Medium chain triglycerides provide a readily available alternate fuel source for the brain and body, besides the ketones discussed above. MCT’S are rapidly absorbed & metabolized into medium chain fatty acids. Medium chain fatty acids readily cross the blood brain barrier & are metabolized by the brain as fuel. Also they are absorbed & oxidized in the liver to rapidly produce ketones, as does the ketogenic diet mentioned above. So the MCT'S actually provide two alternative fuels, the medium chain fatty acids & the ketones. In fact, using MCT'S augments the ketone forming activity of the ketogenic diet.

Another ketogenic compound called, 2-deoxy-D-glucose was used to induce ketones in mice that had been given experimental Alzheimer’s. The ketones decreased the beta amyloid burden in the brain and delayed the progression of brain deficits. Beta-amyloid deposits are part of what induces brain malfunction in Alzheimer’s. Other studies have also suggested a down regulation of the genetic apolipoprotein E caspase-3 messenger RNA expression for Alzheimer's & an improved brain oxidative stress response when brain ketones are increased. Nutr Metab (London) Aug 2009.

Thus we see that MCT’S not only provide their own fatty acid fuel but also help to induce a more reliable ketogenic state, augmenting the Atkins’ diet or other ketone producing diets toward obtaining quicker more reliable ketosis and all the benefits which come with achieving ketosis.

Ketones also have specific neuroprotective properties making the ketogenic diet and MCT’S useful natural alternatives for modifying the progression of any degenerative processes in the brain.

So, after all this explanation, we now can understand what this wife and doctor was noting with her husband & why he functioned best when he followed the correct diet as well as supplementing the MCT’S.

You can obtain commercial MCT oil as a liquid, as capsules, or in drinks. You can also get your MCT’S from extra virgin coconut oil.

Coconut oil has been classified as a “Functional Food”, which is defined as a “food that provides health benefits over and above the basic nutrients.” It is used in the traditional medicine of Asian and Pacific populations. Pacific islanders refer to the coconut as the Tree of Life. It is a primary food source in half the world. Those parts of the world using more coconut oil have less cardiovascular disease. Coconut oil comprises 50% of the dietary fat in Sri Lanka where they have a low incidence of cardiovascular problems.

Coconut oil is solid at temperatures below 76 and liquid above those temps. It is heat stable and good to use for cooking. Fried foods are even not so bad for you if fried in coconut oil. I have certainly enjoyed the coconut oil as a salad dressing, added to various drinks, rubbed on baked chicken before baking (yum, yum), added to vegetable dishes, straight from the spoon, and so on.

Medium chain triglycerides comprise 2/3 of the fat in coconut, and 15% of the fat in palm kernel oils and butter. A smaller amount is found in milk fat, and breast milk. The fatty acid components add to the overall health benefits. The fatty acids are a family of triglycerides containing mostly lauric (50%) , capric (7-10%), caprylic, caproic, myristic, palmitic, oleic, linoleic, linolenic, and stearic fatty acids.

These various fatty acids provide additional health benefits, as they have the capacity to kill viruses, bacteria, and fungi, to expel or kill tapeworms, giardia, and other parasites, and to generally aid the immune system. For instance lauric acid converts to monolaurin in the body, where it then confers antiviral, antibacterial, and anti protozoal properties. Monolaurins are derived only from coconut oil and mother’s milk and are the best fat that mother’s milk has. The monolaurin supports the newborn’s immune system development & the capacity to withstand infection. When mother’s milk is not available, the best alternative food fat for the baby is coconut oil. Nursing mothers also need ample amounts of MCT’S in their diets.

WHEN ARE MEDIUM CHAIN TRIGLYCERIDES PARTICULARLY USEFUL?

Commercial MCT'S were originally formulated in the 50’s for those too ill to properly digest normal fats and oils & to also be used in intravenous nutrition or with tube feeding. MCT’S are used and preferred in those with malabsorption, chronic diarrhea, inflammatory bowel disease, obstructive jaundice, biliary cirrhosis, pancreatitis, cystic fibrosis, celiac disease, Whipples disease, Crohn’s disease, regional enteritis, pancreatic insufficiency, gallbladder disease, and those with tissue wasting. MCT’S are also used in the feeding of newborns and premature babies. MCT’S are essentially nontoxic in acute toxicity tests.

Interestingly, a publication by the US Department of Health and Human Services & National Institute on Alcohol Abuse and Alcoholism lists the following treatment suggestions for Alcoholic Liver Disease:

The terms medium chain and long chain refer to the number of carbon with hydrogen chains making up a fat. Long chain fatty acids ( 11-24 carbon atoms) comprise 98-100% of the fats in our diets. These are in meat, fish, milk, eggs, vegetable and olive oils. The long chain fatty acids include essential fatty acids such as the omega-3 and omega-6 oils. Omega-9 may be essential under certain conditions.

Omega-3 fatty acids are commonly deficient in the American diet. The main sources of omega-3 are fish oil, krill oil, flaxseed oil,green-lipped mussel, perilla oil, and chia seeds. The non-fish oils contain much less of the DHA and EPA than is in fish or krill oil. See my newsletter Benefits of the Omega-3 Fatty Acids for more information.

The best food sources for omega- 9 are extra virgin olive oil, avocados, and nuts. The best oils for cooking are extra virgin olive oil, grapeseed oil, and coconut oil. But you can also cook with peanut oil, avocado oil, sesame oil, canola oil, and the high oleic forms of safflower & sunflower oil.

The problem is most people do not eat a diet which is properly balanced with the appropriate fatty acids in the right ratios. They end up getting too much omega-6 relative to omega-3, or omega-9. The omega-6 oils are high in polyunsaturated fats. This imbalance adds to general inflammatory conditions in the body, as well as other health problems such as cancer.

One of the reasons we end up with this imbalance is that these worse kinds of fats are in almost every processed food we eat and we eat too many processed foods. Polyunsaturated vegetable fats have been artificially created and added everywhere to our processed, packaged, baked, and fried food supply. The initial powerful lobbying campaign, which allowed this to happen, promoted these oils as healthy and low fat. Subsequently they have been shown to be dangerous, adding to the episode of obesity and cardiovascular disease. The longer shelf life for these processed oils was a major selling point. A process called hydrogenation created a longer shelf life for these oils, but also created fragile, unstable, unhealthy molecules, some of which are called “trans fats”. These fats are easily oxidized and create unhealthy free radicals. You want to avoid any substance having the words trans fats, partially hydrogenated, or hydrogenated on the label.

One reason Medium chain triglycerides (6-10 carbon atoms) are so desirable is they do not deplete the body of antioxidant reserves as do other oils because they do not oxidize and create free radicals. Also they do not form harmful by products when heated to normal cooking temperatures, as many other oils.

WHAT ARE THE DIFFERENCES BETWEEN LONG CHAIN FATTY ACIDS AND MEDIUM CHAIN FATTY ACIDS?

MEDIUM CHAIN

LONG CHAIN

Are easily digested and broken down by the body

Are difficult to digest & metabolize

Require no pancreatic enzymes or bile acids

Require enzymes & bile acids for digestion

Require no lipoproteins

Must be packaged & moved with carrier proteins called Lipoproteins

Require no carnitine for use

Carnitine is required for conversion & use

Goes straight to the liver where is converted to immediate source of energy, as are carbohydrates, rather than stored as fat

May help with weight control when included in diet as partial replacement for LCT’s but works best in this regard when combined with a ketogenic diet.

Provides about 10% fewer calories than LCT’s per equivalent amount

Supports heart health

Some LCT’s support heart health & some do not. Can be deposited in arteries in lipid form such as cholesterol

Can be used topically for skin problems such as acne, atopic dermatitis

In studies, decreased staph aureus colonization of the skin

Showed topical anti-inflammatory properties

Omega-3 fatty acids have anti-inflammatory properties

Helps prevent muscle proteins from being broken down to be used as energy

Contains many antioxidants, so resists oxidation

Many of these fats are easily oxidized

Studies have found it to be effective against candida

Contains biologically active polyphenol components

WHAT AMOUNT OF MEDIUM CHAIN TRIGLYCERIDES SHOULD I EAT?

The average person should not eat more than 30% of their calories as fat. Do not eat all your fats as MCT’S. The amount may vary depending upon whether you are trying to enhance ketogenesis & are working on cognitive function, whether you have some of the conditions which do better with the use of more MCT’S, or whether you are just trying to expand the type of fats you use in your diet.

Begin with ¼ teaspoon several times daily to see how tolerated, then graduallyincrease to generally 1-3 tablespoons dailyfor health maintenance and minor problems.Most studies using MCT’S for cognitive issues, or serious problems used 5 tablespoons daily, in divided doses.Excessive consumption can cause abdominal pain, cramps, and diarrhea.This would usually be doses exceeding 30 gms/daily.

Since MCT’S do not contain the essential fatty acids required for optimum nutrition, they cannot be the only source of dietary fat. MCT'S can be substituted for part of other fat consumption rather than added to increase overall dietary fat. A 50/50 ratio works well except for those with medical conditions requiring even more MCT’S and less LCT’S.

Some Studies:

A number of studies support the benefits of using MCT’S in weight loss programs, to boost energy levels, to increase fatty acid metabolism, and to reduce fat deposits in the body.

The research is mixed re the MCT’S improving athletic performance. But some athletes believe it does & some studies suggest it does. Athletes use drinks combining MCT’S with carbohydrates, the drink CLIP 2 is an example of this.

1-In a clinical trial of 40 women ages 20-40 with over 88 centimeters abdominal obesity. Half were given 30 ml/d of soy bean oil and half the same amount of coconut oil. They were to walk 50 minutes daily and eat a balanced low calorie diet. After 12 weeks, both groups had reduced body mass index (BMI), but only the coconut oil group had a significantly reduced waist circumference. The soy bean oil group had increased cholesterol and LDL and decreased HDL (all not good). The coconut oil group had increased HDL only (good). The researchers concluded, “It appears that dietetic supplementation with coconut oil does not cause dyslipidemia, and seems to promote a reduction in abdominal obesity.” LIPIDS 2009 vol 44 #7

2-In a double-blind placebo-controlled study 78 healthy men and women were divided with half being given MCT’S and the other half LCT’S over 3 months and with both groups consuming the same number of calories daily. The body weight and fat decreased in both groups, but in the heavier subjects the extent of decreased weight and loss of body fat and decrease in areas of subcutaneous fat was greater in the MCT than in the LCT group. J. Nutrition 2001, Nov

3- Another 27 day study comparing MCT’S to LCT’S in overweight women found increased energy expenditure and increased fat oxidation in the MCT group, but no overall change in body composition.

These are examples of some of the conflicting studies re weight loss and change in body composition with MCT’S, but the operative issue may be it needs to be taken at least 3 months, with strict comparison re the rest of the diet and exercise.

5-A study compared the fat burning effect of a 40% MCT diet to a 40% LCT diet. The fat burning effect of the MCT”S was double, 120cal vs. 60 cal.

6-Another study compared the immediate fat burning effect of a single meal of MCT’S vs. LCT’S. After the meal the MCT group had 3 times the fat burning effect than the LCT group.

7-Diabetics often have episodes of hypoglycemia (sounds strange doesn’t it?) But they often overshoot on their blood sugar lowering regimens. Since MCT’s are an alternative brain fuel they have been frequently studied in diabetics. Ingestion of MCT’s reversed the hypoglycemia impaired cognitive performance in tests of verbal memory, digit symbol coding, digit span backwards, & map searching. They concluded the MCT’S preserved brain function under hypoglycemic conditions without causing hyperglycemia.

Thanksgiving is here, so our minds have turned
To what time has taught us, to what we’ve learned:
We often focus all our thought
On shiny things we’ve shopped and bought;
We take our pleasure in material things
Forgetting the pleasure that friendship brings.
If a lot of our stuff just vanished today,
We’d see the foundation of each happy day
Is special relationships, constant and true,
And that’s when our thoughts go directly to you.
We wish you a Thanksgiving you’ll never forget,
Full of love and joy—your best one yet!

Maca is an herb plant that grows in the mountains of Bolivia and Peru. It is used to promote energy, support strength,and act as an aphrodisiac, boosting both male & female libido.

Maca Root has been shown to help with:

Balancing hormones, by stimulating and regulating the endocrine system and working as an adaptogen.

Menopausal symptoms. Because maca acts as a hormonal regulator, it helps ease premenopausal and post-menopausal symptoms. It also helps ease hot flashes, vaginal dryness, and acts as an alternative to hormone replacement therapy. It also aids in regulating and normalizing menstrual cycles.

Stimulating and nourishing the hypothalamus and pituitary glands which are the "master glands" of the body. These glands actually regulate the other glands. thus, when in balance, they can bring balance to the adrenal, thyroid, pancreas, ovarian and testicular glands.

Natto 3x is a new triple strength combination of two potent fibrinolytic (anti-clotting) enzymes, nattokinase & serrapeptase. Nattokinase & serrapeptase combined have been shown to support a healthy cardiovascular system Click this link for more information on Nattokinase.

This combination of AdipoStat and Integra-Lean® African Mango Irvingia was developed by Life Extension Foundation to aid in weight loss.

AdipoStat’s performance in clinical studies indicates it can safely deliver impressive results. In a key study, 30 adults with difficulty maintaining healthy body weight ingested 800 milligrams per day. of AdipoStat while following a 2,000 calorie per day diet and were asked to walk just 30 minutes five days a week. A group of equal size was given placebo.*

After just eight weeks, the AdipoStat group:

Lost 4.05 inches of harmful belly fat—2.0 times the amount lost by the placebo group.

Experienced a 2.05 drop in body mass index (BMI)—3.9 times over placebo.

There could be good news on the horizon for folks who enjoy the spicier things in life. Researchers at the University of Michigan Comprehensive Cancer Center say compounds derived from pepper and turmeric could help prevent breast cancer. The study, which appears online in the journal Breast Cancer Research and Treatment, shows that by limiting the growth of stem cells that produce tumor growth, curcumin (from turmeric) and piperine (from black peppers) may be attractive candidates as potential cancer treatments.

While these dietary compounds may kill cancer cells, they aren't strong enough to stand alone in the fight against one individual's case of cancer. Yet, they may be useful in conjunction with other therapies. Talk to your doctor before adding curcumin or piperine supplements to your diet.

ENCOURAGE KIDS TO BE HEALTHY

Everyone wants their children to grow up to be healthy and happy. As parents, it falls to you to encourage your children to develop healthy habits early in life which they can continue as adults. In doing so, the focus should be how much fun healthy activities are, and how much better it feels to be active and to eat properly. Focusing on dieting, weight and appearance can lead children to develop unhealthy attitudes about their bodies and contribute to body image issues which may cause lasting psychological and wellness issues.

Children should start participating in activities at a young age. At two and three, the majority of the classes available are often geared toward parent participation as well. Swimming lessons, for example, are conducted with an instructor leading the parents through a series of activities designed to let children have fun while they get used to being in the water. By five, kids are ready to take classes on their own. Look for classes that match their interests – if your child continually hangs upside down off the swing set, for example, a gymnastics class might be a good idea. On the other hand, if they spend all their time running around the backyard and kicking pine cones, soccer might be a better bet.

Encourage your children's activities and allow them to pursue a variety. Having different kinds of physical activity will be helpful, and will create a more balanced body and mentality. Don't push them further than they want to go with a sport, and if you sense that they are developing unhealthy attitudes, suggest that they step back and try something else. Mix activity classes with at home activity – riding bikes through the neighborhood, playing baseball in the back yard, doing a morning yoga routine, etc. This will help them learn that they can have an active life outside of scheduled classes.

ABOUT DR. SLAGLE

Priscilla Slagle, M.D. is in the private practice of Nutritional and Functional Medicine & Psychiatry in Palm Springs, California.

Dr Slagle has incorporated vitamins, minerals, amino acids, herbs, natural hormones & other natural substances into her practice since 1975, being one of the pioneers in the Alternative Medicine Field.

She also incorporates hypnosis, EFT, and other reprogramming techniques.

Her book "The Way Up From Down" presents her natural "precursor" methods for lifting low moods & relieving the negative effects of stress.